Individual
JENNA VISSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7041 20TH AVE, CENTERVILLE, MN 55038-9737
(651) 407-3631
Mailing address
7041 20TH AVE, CENTERVILLE, MN 55038-9737
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/12/2015
Last updated
08/12/2015
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